Laser surgery in the field of orthopedic surgery is not so many, because of the characteristic of orthopedic disease. Laser become a good instrument if surgeon understand well the nature of Laser. At present time, Laser is applied in Orthopedic surgery as a minimum invasive surgery and a peculiar surgery of Laser. As minimum invasive surgery. Laser is utilized under arthroscope and for Percutaneous Laser disc decompression (PLDD). By the use of Laser, tissue damages is minimum especially in articular cartilage and spinal disc. However, if the orthopedic surgeon does not knew the nature of laser, the major complication, that is osteonecrosis and damage to nerve roots and spinal cord, will come out in and after the surgery.
Laser is also applied for the photodynamic therapy using Hematoporphirin as the selective synovectomy of arthritis including Rheumatoid arthritis.

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Percutaneous Nd-YAG laser disc decompression was performed in 56 patients with lumbar disc herniation. Recovery rate of clinical symptoms was 56%in an average according to JOA scores, and effective results was observed in 61%of patients by Henderson's evaluation of functional capacity postoperatively. No significant decrease of disc height was observed on postoperative radiographs of lumbar spine. Changes of signal intensity either disc or cartilaginous end plate were observed in 14 patients on MRI, however no deterioration of clinical symptoms occurred by this changes. Present results showed that laser disc decompression for lumbar disc herniation was an effective and safe method of the treatment.

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We underwent percutaneous laser nucleotomy (PLDD) using Nd-YAG LASER for cervical disc herniation. Surgical technique, early surgical outcomes, and complications were tested. Success rate in patients with radiculopathy was 90% at one week and one year after surgery. No changes in the X-ray were observed in eleven patients of all. There was no postoperative infection or nerve injury. Surgical outcomes of PLDD were almost satisfactory in this study. When PLDD and other intradiscal therapies were compared, effectiveness of PLDD was observed earlier than the others, and the rate of complication in PLDD was lower.

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Low power laser is applied for the control of pain in many kinds of disease and the control of arthritis including Rheumatoid arthritis.
Evaluating the mechanism of control for arthritis with RA, an adjuvant arthritis of rat as an experimental model of RA was exposured by Nd-YAG Laser. By the exposure of Nd-YAG Laser, an adjuvant arthritis was controlled. After Nd-YAG Laser exposure to an adjuvant arthritis, the histological and immunohistological examination was performed. And the improvement of circulation, decreased inflammation and immunological improvement were shown. By the exposure of Nd-YAG Laser the release of cytocine was examined for RA synovium which was taken by arthroscopic synovectomy. IL-1β. was decreased by Nd-YAG Laser exposure. In clinical use of Nd-YAG Laser to arthitis with RA, the circulation was increased and clinical symptoms was decreased. Diode Laser also was applied for the painful syndrome of orthopedic surgery and evaluted by double blind method. The exposure of Diode Laser improved the pain in many kind of orthopedic disease.

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